Inspection on 18/08/05 for The Merchant`s House

This inspection was carried out on 18th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Merchant`s House 04/04/07

The Merchant`s House 13/02/06

The Merchant`s House 25/02/05

The Merchant`s House 09/11/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Merchants House The Merchants House 80 Prenton Road East, Prenton Birkenhead, Wirral CH42 7LH Lead Inspector Leila Mavropoulou Unannounced 18 August, 2005 10:30 am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Merchants House Address The Merchants House 80 Prenton Road East Prenton Birkenhead Wirral CH42 7LH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Inclusive Lifestyles Mr Anthony McNally Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: To maintain the agreed staffing level of three staff at all times until further discussion with the CSCI. Date of last inspection 25th February 2005 Brief Description of the Service: Merchants House is a large detached property in the Prenton area on the Wirral. It is close to Birkenhead town centre and short walking distance to local shops and public transport. It has an enclosed garden to the rear of the property. The home provides support and personal care to six younger persons (age 18-65) that have a learning disability. The accommodation provided is in single bedrooms with an en-suite facility. The accommodation in the home is specifically designed and equipped to meet the needs of the residents such as: walk in showers, sensory water taps, and specialist wall covering in the ensuties which is has a high resistance to knocks. The annexe on the ground floor is specially designed and equipped to meet the needs of one of the residents. All of the residents require one to one and in some instances two to one staffing level during the waking day. On the ground floor there is a lounge, dining room with a second lounge on the first floor. In addition Merchants House has a studio flat with its own entrance which could be used by the residents family when they visit. Merchants House provide thereuputic programme to promote the residents indepence and inclusion into all aspects of community life with the support of staff. Many of the staff have the NVQ qualification in care and training and support to staff is ongoing to ensure that they have the necessary skills and knowledge to meet the needs of the residents. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which lasted 6 hours over two days. During the inspection the inspector spoke to four staff, three residents and the manager. In addition various residents and staff records were inspected, as well as other records that the home such fire records, maintenance records etc. What the service does well: What has improved since the last inspection? The recording of the residents information has been reviewed and the format of the resident’s care plans have changed to enable staff to access relevant residents information more easily. Three of the residents’ bedroom, dining room and staff room have been repainted. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 6 There has been noticeable effort in trying to make Merchants House more “homely” within the constraints of ensuring the safety of the residents and staff. This is achieved by rearrangement of furniture in the lounge, pictures etc. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4, The home operates a very detailed and prolonged pre-admission assessment to ensure that the home is able to meet the needs of the resident. EVIDENCE: The home has a Statement of Purpose, which sets out the facilities and services provided at Merchant House. This gives prospective residents/placing authority the initial information required to make a decision as to whether or not Merchant House would be able to meet the needs of the resident. However, the senior management and the manager of the home should review the home’s Statement of Purpose to reflect more clearly the philosophy care of Merchants House, with particular reference to the high degree of therapeutic work carried with the residents to develop skills which would enable them to move on to more independent living accommodation where possible; as discussion with the manager was not reflect fully the in the homes’ Statement of Purpose. The manager of Merchants House assesses all new residents prior to admission to ensure that the home has the necessary skills and resources to meet the needs of the resident. The pre-admission process is very lengthy and can take up to six months to ensure that the move of the resident to Merchants House is least stressful as possible. This is achieve by Merchants House staff working with the resident and the staff in their present placement. This gives staff the opportunity to get to know and develop a relationship with the resident. During, the pre-admission assessment the residents make regular visits to The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 9 Merchants House with their present carers, which is initially for a day followed by several overnight stays. During the assessment period the management of Merchant House would assess the resources required to meet the resident’s need and ensure that they are in place prior to the resident moving into Merchant House. This may include specific staff training, equipment furnishings etc. Merchant House would provide respite care on occasions following an assessment of the resident needs for a specific period providing the resident’s needs could be met within the existing staff group. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9, The residents have detailed care plans and risk assessments to promote their health and safety and continuity of care by all the staff in the care home. EVIDENCE: Since, the last inspection the manager has reviewed the homes’ care planning process. The existing system has been refined to enable staff to access all of the resident’s information more easily. There is an individual care plan for each of the resident’s assessed needs, which are discussed by staff monthly at the team meetings, usually when the key worker is present. Following the discussion the key worker complete a report on each aspect of the resident’s care plan to highlight changes in the resident’s needs. These are used to inform the formal multidisciplinary reviews with various health professionals that are held either three or six monthly intervals. At the time of the inspection there was no evidence of the residents care plan being developed with the residents. However, the resident’s family are encouraged and supported to attend reviews. Detail individual protocols have been developed to meet the individual resident needs to enable them to maintain their independence and to access various community facilities. The protocols are strategies to minimise identified risks to the resident in relation to particular activity and to provide staff with guidance on how to manage the situation. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 11 The staff supports the residents to make decision over their daily lives as evidenced during the inspection as one resident was looking through holiday brochures to choose where they would like to go. The residents are provided with a secure place to keep their valuables/monies in their bedroom and staff would support the resident as required. Observation during the tour of the building show that restrictions are placed on many of the residents to promote their health and safety, these include clothing and residents equipment being locked away when not in use. Also, in some instances access to their toiletries is restricted. Restrictions placed on the residents are recorded in their care plans and the reasons why. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16,17 The management of the home is committed to ensuring that the residents of Merchants House access educational and social activities to develop their skills and promote their emotional/psychological well being. EVIDENCE: Observation, discussion with the resident, staff, management and residents records show that each resident has an individual activity programme which reflect their interests. These include shopping, swimming, snoozelem, college, gardening etc. The activity programme show that the residents access various community facilities regularly as the home has its own transport. Residents access to community facilities is not restricted by staffing level as, all residents have one to one staffing. All of the residents will be attending college from September with the staff at Merchant House to follow different courses of their choice. The activity budget for individual resident is generous, thus enabling residents to engage in a wide range of community activities. Observation of residents bedrooms show that the staff support and encourage the residents to maintain interests they had prior to going to Merchants House and develop new interests. These included computer games, collection of videos and CDs, pets etc. Currently, one of the residents have two rabbits and The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 13 the staff at the care home are looking at ways in which more independence could be given to the resident in caring for her pets, such as making an enclosure in the garden for the rabbit. A holiday is included in the weekly fee and the staff from Merchant’s House accompanies the resident. The resident chooses the holiday venue and risk assessments are developed prior to the resident going on holiday, e.g. one resident is going to a cottage in North Wales, others are going to activity holiday near Blackpool. The home encourages family and friends to visit as the home has an unrestricted visiting policy. The staff at the care home supports the residents to maintain contact with their family and friends through providing accommodation in the home where family/friends can stay overnight if they have travelled a long distance. In addition staff would accompany residents to their family home for a weekend so that they can maintain some degree of family life. Observation during the inspection showed that right to privacy are upheld. This was evidence by staff seeking permission before entering the resident’s bedroom and the way in which staff interacted with the residents in various activities. The residents have access to all parts of the home except one resident that is wheelchair user. The menus are currently under review to ensure that the resident’s have a healthier and more balanced diet. Two choices are offered at mealtimes and if neither of these is acceptable alternatives are offered to the residents. A record is maintained of food provided to the residents. The home would cater for residents that require a special diet and the staffing level as observed during teatime showed that appropriate assistance is provided to residents in a manner, which promote the resident’s dignity. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 The staff at Merchant’s House monitors closely the health needs of the residents to ensure that they receive appropriate support and care from appropriate health professionals. EVIDENCE: Where residents require assistance with transferring the home provides suitable aids and equipment to meet the specific needs of the individual. All aids are assessed by the physiotherapist and are serviced at regular intervals. Use of aids is reviewed regularly as evidenced by replacing one of the resident’s to a “high low” to improve their comfort and monitoring of their sleep. The residents choose staff that work with them closely through their interaction with staff and other non-verbal communication. In addition monitoring of certain activities, which are linked directly to particular staff members would also indicate indirect choice by the resident of staff working with them. All aspects of the residents’ health is closely monitored by staff through various assessments and changes in the resident health is referred to the resident GP in the first instance or directly to specialist health professional where this is possible. The staff at the care home accesses support and advice from speech therapist, psychologist, continence adviser and other specialist health professionals as necessary. The residents receive regular health checks from the optician, dentist and chiropodist treatment regularly to ensure that their physical health needs are met. In addition all resident receive regular aromatherapy treatment to The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 15 promote the residents emotional wellbeing, which is included in the resident’s weekly fee. The home operates a monitored dosage system for the administration of the residents’ medication. Records are maintained of residents medication received into the care home. The administration records were well kept and tidy. Inspection of the homes “homely remedies” (non prescription medication) policy and discussion with the staff and manager indicate that this policy should be reviewed to ensure consistency in the administration of homely remedies. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The home has various policies and procedures in place to protect the residents from abuse. EVIDENCE: The home has a complaints procedure and residents, family and staff are encouraged to use the home’s complaints procedure if they are dissatisfied with any aspect of the service provided at Merchant’s House. The home maintains a record of complaints and has given timescales in responding to complaints. Various policies and procedures are in place to protect the residents from all forms of abuse. The home implements its policies fully as evidenced in recent months by an incident in the home. All staff receive training in managing physical and verbal aggression and protocols would be developed for the management of individual residents where necessary. Policies and procedures are in place regarding residents’ monies, through providing a secure place for the storage of resident’s monies/valuables. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26,30 The home benefits from planned renewal and maintenance to promote the health, safety and well being of the residents. EVIDENCE: The accommodation in the home is bright and cheerful, as many of the rooms have very large windows. The communal areas are furnished with quality modern furniture reflecting the age of the residents and their needs. The communal areas can be used for a variety of purposes and all areas on the ground floor is accessible to all of the residents as there is s chair lift to assist wheelchair users over a few steps from the annexe to the dining room and the main lounge. The premises comply with the local fire service requirement. Recently the environmental health officer inspected the home and no requirements were made. The building has a planned renewal and maintenance programme. Since, the last inspection three bedrooms have been redecorated, the dining room and the staff room. Where possible the resident is encouraged to choose the wall decoration and to bring personal belongings into the home. This was evidenced during the tour of the building as many residents had their own television, personal computer, music centres, ornaments etc. The residents The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 18 would be provided with a key to their bedroom once they are assessed as being able to so safely. Policies and procedures are in place for the prevention of spread of infection and the laundry facilities is sited away from the food preparation area. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,35,36 The staff at Merchant’s House receives regular training and supervision to ensure that they have the necessary skills and knowledge to provide the appropriate care to the residents. EVIDENCE: The home staffing level is geared towards meeting the residents’ needs. Most of the residents have a one to one staffing and another has two to one. The care and support in the home is intensive due to level of supervision required by the resident. However, staff undertake their work in a manner which is least intrusive as possible within the constraints of the resident’s care plan and risk assessment as observed during the inspection. Discussion with the manager and staff indicated that they are satisfied with the level of support provided by the management of the home. This could be evidenced through the staff appraisal. The home nearly recruited staff to its vacancies. In the interim period the home’s bank staff is used which provides continuity of care to the residents. The homes recruitment process is fully implemented as evidenced in the staff records inspected to ensure that the safety of the residents. The records inspected showed that two written references were obtained and Criminal Records Bureau check has been obtained before staff commencing employment at the care home. Discussion with staff indicated that they had been given a written terms and conditions of employment and that they were The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 20 inducted into their role. The induction consisted of three days shadowing another member of staff, moving and handling and training. Each staff is issued with a code of conduct and handbook together with a folder containing information and workbooks covering various areas of practice which the staff member has to complete. These are discussed with Project Leaders during supervision and sign off as completed. Weekly team meetings are held to discuss and review the residents’ care plans. In addition regular team meetings are held and where necessary an external facilitator would be made available to provide support to the staff. The Project Leaders provide one to one supervision to the Support Workers and the manager provides supervision to the Project Leaders. All staff receive training on managing physical and verbal aggression and policies and procedures are in place to provide guidance to staff. The manager appraises staff at the care home every six months to review their performance. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,41,42,43 The management of the home provide strong leadership and support to staff to promote the residents’ independence and choice in all aspect of their daily lives. EVIDENCE: The manager of the home has made an application to the Commission to become the registered manager. He has many years experience of developing services within the care sector and has a good rapport with residents and staff. Discussion with staff indicated that the manager is approachable and promote clear sense of direction and leadership, as to how the aims and objectives of Merchant’s House would be achieved. He is currently working towards a MSc in Mental Health. The management team of Merchant’s House monitors regularly the quality of care provided to residents through regular internal and external residents reviews and through the monthly visit by the Responsible Person. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 22 The homes record keeping is good and well maintained and residents or their representatives would have access to their records in accordance with the home’s access to information policy. The health and safety of the residents and staff is promoted through regular review of residents’ risk assessments, staff training and development and maintenance of equipment and the premises. In addition regular fire tests are carried out and hot water and food temperatures are maintained. The home informs the Commission of any on toward incident to the residents or significant incident in the care home and what action has been taken. There was a current Public Liability Insurance in place and there are clear lines of accountability in the care home and with senior management as evidenced in discussion with the manager. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Merchants House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 3 3 3 F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 1 19 24 36 Good Practice Recommendations The registered manager should review the homes Statement of Purpose to clearly reflect the aims of Merchants House. The registered person should review the homes medication policy on homely remedies to make it more explicit and provide continuity of care to the service users. The registered person should repaint/decorate the first floor lounge, paint the ceiling in dining room and bedroom 3. The manager should ensure that all staff receive one to one supervision in accordance with the homes supervision policy. The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 10 Duke Street Liverpool, L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Merchants House F52 F02 S59613 Merchant House V249159 180805 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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